breast cancer reality

This, I promise

Understandably, I have been thinking a lot about my priorities since my oncologist told me my cancer is Stage 4. What do I want to do with whatever time I have left. Don’t get me wrong – my oncologist at no point has told me to start getting my affairs in order and preparing for death.

However, the thing about metastatic cancer is that you have no way of knowing if you’re going to be one that responds well to treatment or poorly to treatment. Right now, as far as we know, the cancer is only in my bones: confirmed in my sternum and possibly in my spine. Cancer is smarter than all of us, and I have no doubt it’s already thinking of where it wants to go next.

As I recover from my surgery, I have been thinking about what I really want to focus on and try to achieve, and what time-sucking activities should I just let go. I hope and I pray that the side effects from the upcoming endocrine therapy will not be so bad so that I can go back to work.

I want to go back to work, I really do. I thrive in a structured environment, and I enjoy having a purpose and teaching others what I know. I’m an internal auditor, which I get isn’t like making scientific breakthroughs or saving lives. I contend that even in the normal, every day jobs, you can always make a difference in someone’s life by small acts. Maybe my enthusiasm for research and dogged determination to figure out the answer will rub off on a fellow coworker?

I also work for a company and a team that know about my stage 4 diagnosis. I truly believe that this company, if possible, will want to help fight against metastatic disease and the criminal underfunding of metastatic breast cancer research. I still have zero desire to be, what I call, cancer famous. If I have to put myself out there, though, to put a face to metastatic breast cancer and the importance of research, I will do it.

This, I promise, is my solemn vow: I am not going to go quietly. Please don’t mistake this statement as some declaration of mine that I’m going to “fight” cancer and win. Cancer is not a battle or a fight, and I’m not going to “beat it” or “win.” It is a deadly disease that will eventually kill me just like it killed my mother (hmm, maybe I shouldn’t be a motivational speaker, eh?).

Two generations of Metastatic Breast Cancer

I intend to make as much noise as I can for as long as I can about the importance of metastatic cancer research and the insidious PTEN mutation that caused my cancer. When I was considered to be an early stager, I was often described as outspoken or very vocal. Well, guess the fuck what… that’s just a preview of what’s to come. Ideas are brewing.

Metastatic breast cancer killed my mother, and I was told I had stage 4 metastatic breast cancer at the same age she was when she died. I was maybe 3 years old when my mother was first diagnosed, so this disease has been a part of my life for more than 3 decades, almost 4. I’ve never wanted to be defined by cancer, but we don’t always get what we want.

I’m not going to go quietly. I plan to do something about this, and it’s not always going to be positivity and rainbows. If I’m angry, I’ll be angry. Same goes for sad, depressed, happy, or hopeful. I’m going to feel all the feelings, and when the time comes for me to meet my mother again, I hope she knows I gave it my all.

10 Years, 10 Days

September 22 marked 10 years since I learned that I had Stage 1b breast cancer. 10 days after that, I found out that my breast cancer has returned, but this time, I am stage 4. I have metastatic breast cancer, which means it’s treatable, not curable. I will be in treatment for the rest of my life, however long that may be.

Let’s back up a couple months. In early August, I tripped and fell during a trail run, and I body-slammed myself into the ground. Not only that, I was wearing a hydration vest with two detachable water bottles located at each boob. One second I was running and the next second, I found myself face first on the ground, feeling like I had the wind knocked out of me times 100.

My boyfriend ended up taking me to the ER, where the doctor ultimately diagnosed me with a chest wall contusion and a concussion. The chest X-ray and spinal X-ray didn’t show anything concerning.

In early September, I had routine bloodwork ordered by my oncologist done. He had been monitoring my rising CA 15-3, which kept slowly rising over the previous year or so. Dr. C didn’t seem concerned about it, but I certainly was. Dr. C knows cancer, but I know Lara. To ease my concern, Dr. C told me that he would normally just re-test the tumor markers in 3 months and see, but he knew I was very concerned. He said that he would order a bone scan and a CT scan to put my worry to rest. (Haha.)

Both scans showed potential metastatic disease in my sternum, and the CT scan showed a potential lesion in my T11. When I learned this, I did not take the news well at all, and why should I? I had the worst panic attack of my adult life and had to take off work for the rest of the afternoon. I went numb in my face, my abdomen, and I lost feeling in my hands. I knew that day this was it.

My loved ones repeatedly said, “No, no, no. These scans are showing the result of your fall.” Fair argument, and at times, I did want to believe it. Ultimately, deep down, I knew this was stage 4 due to the fact my tumor markers were high. I have always known this was going to happen because this is what my body does.

I had a bone biopsy of my sternum, and not going to lie, that was one of the most horrendous procedures I have had done. When the radiologist inserted the needle into my sternum to numb it, I screamed in pain. While screaming, I heard them say, “Be still!” Hahaha, fuck you. I’m doing my best.

Fast forward to present day, it appears that my cancer is contained in the sternum and has not traveled to any other organ. If that is indeed true, then that is a big WIN for me. (I learned a new term – it’s called oligo.) It means we can radiate the cancer in my sternum to high hell, and then I start taking an AI. No need for chemo for bone mets. My other “good” news is that the metastatic breast cancer is estrogen and progesterone receptive and Her2 negative. That means I have a lot of options in AIs. The goal is to get the cancer back to zero and keep it there for as long as possible with AIs.

Am I devastated? Oh God, yes. I am gutted. I cry a lot. This is my literal nightmare come true. My mom was also diagnosed with Stage 4 breast cancer when she was 40, and died before she turned 41. How can this not mess with my head? I am my mother’s daughter.

I have to take all this minute by minute, or hour by hour, or day by day. I have a great support system here to throw me a life preserver when I feel like I am absolutely drowning. My team of doctors does include a psychiatrist to help me deal with the emotional bitch-slapping that stage 4 cancer brings.

I guess this means Get Up Swinging is back. Instead of making one billion phone calls after each update, I just plan on updating this. I need to get back to my introvert ways, and keep my inner circle small. All these phone calls have left me just absolutely drained and exhausted. I understand people who care about me want to check in with me and make sure I’m okay, and I am very appreciative. I also want to eventually transition to an easier way to keep anyone who cares apprised of my health.

Plus, this will be the best way to document how I keep cycling through the 5 stages of grief, and vent about cancer-related topics that piss me off (i.e., inspiration porn, or calling cancer a battle). Also, OF COURSE I WOULD BE DIAGNOSED WITH STAGE 4 BREAST CANCER DURING BREAST CANCER AWARENESS MONTH. Argh. It’s like pouring salt in a large gaping wound.

So… stay tuned?

Why I Am Still Anti-Komen

In early 2014, I wrote a blog post about why I was against breast cancer juggernaut Susan G. Komen Foundation. It was shared, pinned, tweeted, discussed. While the blog post was shared and liked by many, I don’t know the extent of the reputation hit I may have inflicted upon Nancy & Co. I truly hope I inspired many to donate their money to much more honorable charities.

Well, now I am here to report on where Get Up Swinging and Susan G. Komen still stand. To the surprise of no one, I am very much still anti-Komen, and I do not see that changing any time soon (please see below for a list of organizations doing amazing work).

I do not plan to re-hash all the same reasons I have already cited. That’s the beauty of Nancy & Co: they keep giving us new and improved reasons to despise them and what they are doing to stand in the way of real change. Today would have been my mother’s 69^th birthday. She died at the age of 40 from metastatic breast cancer.

Nancy, Nancy, Nancy

In a November 5, 2015 letter to the New York Times, my favorite former CEO was not happy about a very well-reasoned article, “A Growing Disenchantment With October ‘Pinkification,’”also published in the New York Times, which had valid points of views from those not wearing Pink Ribbon glasses. Did Nancy listen to her critics and go, “Man, we’ve really divided the community for which we are trying to help” Did she do any self-reflection and think, “I need to turn my focus back on the promise I made Susie.”

Of course not. Nancy didn’t address any of these real pressing issues currently happening in the breast cancer community. Instead, all she did was regurgitate Komen’s history and ends her op-ed with the tone-deaf statement: “Pink Ribbons matter!”

The Pink Ribbon has enabled Komen to stage Races for the Cure with more than 1.5 million participants, partnerships in more than 150 countries and the engagement of more than 100,000 volunteers.

Oh boy, Nancy. This is another example of why I think you are an evil woman. You don’t get it, and you don’t want to get it. What about those who are on their fifth line of treatment or waiting to get into a clinical trial in hopes for another six months with their families? All you care about is your money-making Pink ribbon empire and your meaningless ribbon, aka the symbol of your life’s wealth.

There was one point in the article, and it’s an excellent point and one that you would think would make The Breast Cancer Charity go, “Holy shit, we seriously have to fix this!”

For all the awareness, they note, breast cancer incidence has been nearly flat and there still is no cure for women whose cancer has spread beyond the breast to other organs, like the liver or bones.

So, congratulations on patting yourself for your ability to rally others around a cause that has affected so many people. But what about the 40,000 dying every year, a mortality rate that hasn’t changed in two decades?

No, Nancy. Pink ribbons do not matter. The lives of the 40,000+ dying of metastatic breast cancer each year in the U.S. matter. Their partners, their children – the lives of all who have been diagnosed and will be diagnosed – they matter. They should be the priority and Nancy & Co. act as if these valid complaints are mere annoyances, like we are a bunch of Internet loud mouths. The average lifespan of someone diagnosed with stage 4 is 33 months, and a pink ribbon isn’t going to change that. We need change. Now.

2015 marks the first time Komen lets you make a donation to metastatic breast cancer research

This past October marked the first time Komen allowed its donors to allocate where they want their money to go, and research toward metastatic breast cancer was one of the options. It’s 2015, and this is the first time they have done this. Why has it taken so long? Could it be that the Komen push-back from all of us Internet loud mouths made some Komen folks realize that their priorities are jacked up?

However, this option only came about mid-October, and it was initially advertised as an option only available until the end of October! What the deuce? Did I miss the memo that metastatic breast cancer goes away when the calendar reaches November 1?

I guess they listened to others also going, “Um, what? This is only an option until October 31?” and changed their minds. If you make a donation to Komen, you can still choose your donation to go toward metastatic breast cancer research.

Of course, though, this is still Komen, and they will always find a way to take your money, as pointed out by Bravery, Grace and Badassery.

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Does Komen really need that much financial help for its administrative costs that it still insists on taking funds for metastatic breast cancer research? Get the hell out with this nonsense.

This organization has been claiming to be in this “for the cure” for the previous three decades. Shouldn’t research for metastatic breast cancer be the primary focus so many, many years ago? The only type of breast cancer that kills is metastatic breast cancer.

Komen likes misleading statistics

During Pinktober, the Susan G. Komen Foundation posted a pastel, feminine looking graphic with words and numbers together, which would lead you to believe that we are WINNING this fight on breast cancer:

Ugh. Ugh. Ugh some more.

The five-year statistic is bull, it’s just plain bull. It’s a misleading statement for a national organization to make, and all it does is make the general public LESS aware about breast cancer. I’m sure all the Komen supporters saw that graphic on Facebook and said, “Yes, we are winning! Well done, everyone. Well done.”

Folks, if you’re reading this, please know that you can still have a breast cancer recurrence after five years. The cancer doesn’t just peace out once it’s been five years since your initial diagnosis. We have been led to believe that five years is this magical number and you showed cancer who is boss. Realistically, though, you can recur 5, 10 or even 15 years after your initial diagnosis, so you can still die from breast cancer but be counted in this bogus statistic. Theoretically, someone can have an early stage diagnosis in 2012 and have a metastatic recurrence in late 2015. If they are still alive in 2017, then they are counted in that statistic, even if they die on January 1, 2018. Do we tell them as they are dying, “Way to go, Jane, you made it past five years since your initial diagnosis. You are a winner.”

Komen, for the love of Pete, quit sending misleading statements out to the general public that we are winning when the mortality rate hasn’t changed in the previous two decades.

Check out my friend, AnneMarie, crunching some numbers.

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I couldn’t agree with this any more.

Frankly, I’m tired of breast cancer being portrayed as the feel good cancer and being held up as a shining example for early detection which works sometimes or even most times but not all the time and that part of the messaging is conveniently left of of every discussion about early detection. It’s buzzkill. It detracts from the message that mammograms are unilaterally helping save lives. Mammograms are detecting cancer earlier and earlier thanks to constant improvements being made in imaging devices but early detection is just that. Early Detection. And early detection is not a guarantee.

Komen and its representatives treat metastatic breast cancer patients like a nuisance

Beth Caldwell, who writes over at the Cult of Perfect Motherhood, recently attended the San Antonio Breast Cancer symposium. She wrote about her encounter with a member of Komen’s Scientific Advisory Board:

This week, Kelly Shanahan and I had a conversation with Powell Brown, a member of the scientific advisory board for Komen. We explained to him that the metastatic community is largely dissatisfied with the small percentage of funding that Komen spends on research, since research is the only thing that will save our lives. I told him that they need to change their split between the national and the locals so that more money is available for research. His response was that he doesn’t believe Komen will change that ratio, and that Komen would not begin funding more research until the metastatic community gets behind Komen. He said that if we want Komen to spend more on research, we should participate in their fundraising efforts. He said that more fundraising would mean more money available for research. I told him there was no way that our community could get behind an organization that chooses to spend its money on things other than saving our lives, especially given that there are other organizations that spend a much larger proportion of their funding on research, including BCRF, which now outstrips Komen in dollars spent annually on research. His response was that if that’s how we feel, we should just support BCRF instead. And he walked away.

This is what a national leader for Komen feels about the metastatic patient. We are disposable because we don’t fundraise for them. Do not let them fool you into believing they care about us. Our lives don’t matter to them. And that’s why Komen is irrelevant to us. We must and will save our own lives.

Holley Kitchen, whose direct and moving video went viral, also had an encounter with a Susan. G. Komen foundation representative:

Susan G. Komen Foundation has proven time and time again that it cares about money and donation$, and the lives of those with metastatic breast cancer are secondary. Metastatic breast cancer is what killed Susan G. Komen, a real woman who died way too young. Yet when those with stage 4 have stood up to the organization and its representatives, they are told time and time again that maybe Komen will care if they begin raising money for them.

So what’s the point of my anti-Komen diatribes?

Finally, just because I think Komen is an awful organization that has gone way off tracks, it does NOT mean I don’t want you to stop donating toward breast cancer research and programs. There are so many wonderful organizations that have a mission statement, and (gasp) they are sticking to it.

Why do I keep hating on Nancy & Co.? Welp, I want to highlight organizations that are awesome and making a big roar out there. Please consider throwing your support behind these organizations.

Metavivor – 100 percent of your donations goes toward researching metastatic breast cancer, and they raise money by selling merchandise.

The IBC Network – Did you know that breast cancer can occur without presenting as a lump? Inflammatory Breast Cancer is mostly detected when the cancer is late stage or tragically, stage 4. It’s an aggressive cancer, and it’s definitely not one that’s ever discussed during our annual Pinktober. Terry Arnold over at IBC Network is a tireless advocate.

Met Up – This is an activist group, which was co-founded by women who have metastatic breast cancer. Read their goals, get involved. Help their voices be heard. You cannot call yourself a true breast cancer advocate if you only want to help the “survivors.”

We have so much work that needs to be done. Recently, the New York Times reported on October 29, 2015 that the incidence rate between white women and African-American women are now equal for the first time. Previously, women of color were less likely to be diagnosed with breast cancer, but more likely to die from the disease. Now that the incidence rate is equal, well, does that seem like good news for women of color? Not in the slightest.

Over all, a black woman given a breast cancer diagnosis is 42 percent more likely to die from the disease than a white woman with breast cancer. An analysis of breast cancer mortality trends in 41 of the largest cities in the United States, published last year in Cancer Epidemiology, found that in some cities the risk is even greater. In Los Angeles, a black woman with breast cancer is about 70 percent more likely to die from the disease than a white woman is. In Memphis, black women face more than double the risk. Black women also are less likely than white women are to be given a diagnosis of early stage disease, and more likely to be given a diagnosis with later stage, and less treatable, tumors, according to the report.

Don’t give up on the cause, even though Nancy & Co. have lost their way.

Pinktober is coming

In matter of days, October will be upon us once again, and everywhere you look will be draped in pink ribbons and emblazoned with such words, like, “Brave!” “Survivor!” “Sisterhood!” “Strength!” When you turn on daytime morning television, the networks will be featuring early-stage survivors and once again, ignoring those living and dying from metastatic breast cancer. If you’re a fan of professional football, the NFL will be featuring bright, attention-grabbing pink gloves, shoes, and T-shirts, all for breast cancer awareness month (never mind the fact that October is domestic violence awareness month, and the NFL should seriously focus their attention on that problem). Also, the NFL donates “shockingly” little to breast cancer causes anyway.

Friends, if you are like me and recoil at the pink tchotchkes and offensive T-shirts with puns about breasts, then come sit next to me. We can plug our ears, close our eyes and sing happy songs to drown out all the noise because that’s what this is: noise.

However, if finding a corner to hide from the Pink Ribbon Biz Business until November isn’t feasible due to family, children, jobs, that sort of thing, then there are ways to survive with your sanity intact. Here are some ways you can fight back against Pink Ribbon Crap Spewing Machine, and most importantly, help those with breast cancer who need your support.

Research > awareness

By the hammer of Thor, the word awareness has lost all meaning. It really has. I would love to find that one person residing in the U.S. who isn’t aware of the existence of breast cancer and ask them where they have been for the past two or three decades. A cave? A cabin in the woods? The fact of the matter is that we are all aware. In fact, we are all so aware that the general public doesn’t know much about breast cancer except for its existence. With all the T-shirts, coffee mugs, bumper stickers and the thousands of other breast cancer-related products doesn’t teach anybody anything beyond the fact that breast cancer exists.

Did you know that approximately 40,000 die from metastatic breast cancer each year? My mom died from this disease in 1987 at the age of 40, so I have been aware of the fact that breast cancer is deadly since I was only 7 years old.

Did you know that men get breast cancer, too?

Did you know that breast cancer can present with a lump and if so, do you know the warning signs to look out for?

Did you know there are multiple subtypes of breast cancer, such as estrogen positive, Her2+ or triple negative breast cancer?

Did you know that a strong family history and/or genetic makes up small number of breast cancer diagnosis? (American Cancer Society estimates that number to be approximately 5 to 10 percent.)

If you have had a friend or family member go through or die from breast cancer and you want to help in a meaningful way, then support organizations who are researching breast cancer. Stand Up to Cancer, and the Dr. Susan Love Research Foundation are pretty awesome organizations. Personally, I support the organization Metavivor since 100 percent of their donations go toward research grants. I know I have made it very clear why I abhor the Susan G. Komen foundation, which leads me to my next point…..

Think before you pink

This is just a great general rule to live by in a world saturated with pink products. If you are thinking of purchasing a product that says that X amount of proceeds go to X charity, then do a little research before buying the product. Questions to ask: is this a charity I feel comfortable receiving my money, or would I be better off just making a donation myself and writing off a tax deduction? You can research non-profit organizations on Charity Navigator.

Susan G. Komen receives 2 out of 4 stars, and as of September 27, 2015, it has an overall score of 78.97. It scored 70.53 percent in overall financial and 96 percent in accountability and transparency. Judith Solerno, CEO, received $209,120 in compensation, and Nancy G. Brinker received $480,784 in compensation (more than twice her CEO’s salary?).

Susan Love Research Foundation receives 3 out of 4 stars, and as of the same date, it has an oval score of 85.07. The foundation scored 80.09 percent in overall financial and 93 percent in accountability and transparency. Susan Love, president of the organization, received $225,000 in compensation.

Another important question to ask, according to the Breast Cancer Action organization:

What is the company doing to ensure that its products are not contributing to the breast cancer epidemic?

Please see Breast Cancer Action’s website for examples of more than questionable campaigns created in the name of breast cancer awareness.

Breast cancer is not a game – it’s a serious, deadly disease.

Weeks ago, it was brought to my attention that a new breast cancer status awareness game began. I may have sprained an eyeball from rolling it so hard at the stupidity of it this year, something about leprechauns or speeding tickets. I can’t keep up, nor do I want to keep up with this. Breast cancer is NOT a game, or a reason to take off your bra for… some reason that still doesn’t make sense to me.

Whenever I have seen this “game,” I have this conversation play out in my mind:

Me: Friend, I saw that you posted a weird status about getting out of a traffic ticket with a boob, and I know what you’re doing. Stahp. Just stahp.

Friend: But… I’m raising awareness for breast cancer? Isn’t that something you want?

Me: You haven’t raised awareness for anything except that you fall for stupid games and feel compelled to pass it along to unsuspecting folks on your friends list. You are literally helping nobody by this status.

Friend: You’re an asshole, Lara.

Me: Why that may be true, it doesn’t take away from the fact that you are literally helping nobody by this. Nobody. You haven’t shared any facts, links to any good blogs, organizations or call to actions. Literally nobody has come out of this the wiser.

Friend: [Unfriends Lara]

… and scene.

We can do this, Get Up Swinging friends. We can get through this Pinktober, and we will live to tell the tale.

Mets Monday: Carolyn

Everyone, please meet my friend, Carolyn.

When were you diagnosed and at what age? What type of breast cancer (i.e., er+ or triple neg)?

On May 1st, 2009, I was diagnosed with stage III, er+ pr+ HER2+ (or triple positive), breast cancer at the age of 48, a few days before my youngest son turned sixteen. Due to the extreme growth of the breast tumour and other symptoms prior to the mastectomy it was speculated that I had inflammatory breast cancer but it was not noted as such.

On July 29th, 2012, at the age of 51, I was diagnosed with metastatic breast cancer (stage IV) after it was finally determined that the pain I had been in for many months was due to a breast cancer tumour destroying my C6 vertebra. This fact was missed by radiologist(s) in two CT scans until a neurologist found it while reviewing my older scans.

Inflammatory breast cancer hit my remaining breast in October, 2013. While the pathology remains triple positive, it can’t be said with certainty that it was due to metastasize or a new occurrence.

What is life like as a metser?

Difficult, joyful, exhausting, uncertain, some days more painful than others, some weeks I can’t manage the dishes or get off the couch, some days I can dance. For each person living with MBC there is a unique combination of conditions, variables, treatments, response, and progression of disease. I’ve yet to embrace the term “new normal.” There is nothing normal about life with metastatic cancer, new or otherwise.

For me, life happens in the spaces between my examinations, blood work, and IV infusions. Every three months I have CT scans to head, neck, chest and abdomen, which includes IV contrast injections. Every two months I have an echocardiogram to determine how my heart is coping with my infusions of Herceptin, which is much preferable over the many muga scans I had during my first year with that drug. Full body bone scans, MRI’s, and x-rays are intermittent.

While life happens I’m plagued with constant neck spasms which cause my head to move to the side repeatedly during the day, a distended, firm carotid artery, painful cramping in my chest, neck and esophagus, and an uncomfortable, often painful, upper spine due to spine surgery and the titanium cage, rods and screws. When I yawn, I can’t swallow or breathe well until I massage a neck cramp away.

The treatments and surgeries I’ve undergone over the last seven years have taken a toll. I have peripheral neuropathy, my extremities are numb full time. I’m prone to trip as I can’t feel my toes. My hands wear invisible gloves that I can’t remove. Fibrosis (scarring) and adhesions are also a pain in the neck, chest, ribs, back, shoulders, etc. Two of my bottom teeth are hanging on by a thread, and some of my upper middle gum came off during my neck radiation. There are other ongoing and permanent side effects as well, including cognitive decline.

My favourite moments: Reclining in my lazy boy to relieve symptoms while chatting with my youngest son and listening to his favourite music. When my two older sons and daughter-in-law come to call. Tea with my systir and niece. Laughing with my family during our visits, dinners and events. Tending and loving my eight month old grandson, a joy I didn’t think I’d experience once diagnosed with metastatic breast cancer. Walking with my friend and her dog.

When my sister, brother, sister-in-law, and I get together with our children and our Mom, breast cancer is no longer so very present in my mind. It took me almost six years to get to this point.

The most disconcerting issue I find is the uncertainty. We just don’t know how long we have left to live after a metastatic breast cancer diagnosis, when we will progress, what – or if – treatments will be available when we do, nor what type of death we can expect. We could live the median of two to three years, or we could be an outlier, that infinitesimal percentage of people who live 8, 10 years, or longer. It messes with your mind, your sleep, your resolve.

What type of misconceptions about breast cancer have you encountered? Has anyone ever said something ignorant to you, obviously not knowing what stage 4 breast cancer is?

When you have breast cancer, you are never cured, no matter what stage you were originally diagnosed. There is no cure. If you were not diagnosed with MBC from the start, Metastatic (aka stage IV) breast cancer can become your reality at any time; a year, a few years, or many years after your original early stage diagnosis. I have learned that many people, with or without breast cancer, are not aware of this fact.

I’m continually told, “you beat it once, you’ll beat it this time!” No. I will not. Nor did I beat it the first time. It is not under my control. We manage it, while it grows in our bodies and attacks our bones, our other organs, our brains, until we can’t manage it any longer.

I find it is an innate human desire, for most people, to comfort and somewhat coddle those who are going through early stage breast cancer. While encouragement, support, and hope is most certainly warranted and necessary, I feel that the hard truths must be given as well. The misconception being, that we need to be coddled. I don’t believe we do.

One day at the grocery store a young man at the check out asked me how I was. I said that I was fine, that particular day I was telling the truth even though I was in pain. He then went on to inform me that he had a cold, his girlfriend left him, and he hated work. I don’t know what possessed me, but I asked him, are you dying? He looked a little stunned, and didn’t respond, no doubt thinking I was off my rocker. I couldn’t believe I had asked that, perhaps it was due to large pink sign above his till, and the many products with pink ribbons that surrounded me. I then explained that I had metastatic breast cancer, stage IV, and that it was terminal, it will kill me.

He said, “No one dies of breast cancer anymore, my Mom died of it, but they fixed it.”

My heart sank, for more than one reason.

How do you think the Pink Ribbon culture has harmed those with stage 4?

The Pink Ribbon culture has overwhelmed us with profit minded individuals and corporations who claim to be altruistic in their goals. I’m sure most people are quite sick of pink and zone out when pink is shoved in their face, not just during Pinktober, but all year long. I know I am. Quite sick of it. But breast cancers association with pink is ingrained in our lives and I doubt it will be going anywhere soon, and I’d like to see the focus on donations and fundraising shift almost fully towards research and education.

Mainstream media could help change direction, but I’m afraid that with the pink, comes the desire to show the happy survivor, the hope and the dreams, rather than the approximate 30% of us with breast cancer who will become metastatic and die. This attitude has been slightly changing of late, let’s hope the momentum continues.

The pink ribbon, originally salmon coloured, was introduced to create a much needed awareness of breast cancer. And while breast cancer awareness is still important in many countries, awareness of metastatic breast cancer is sorely lacking in all. The messages from these awareness campaigns have sanitized our disease, not to mention partially obliterated the reason behind the original intent of the pink ribbon movement. Pink ribbon campaigns in the marketplace are quite lucrative, a great way to bring in consumer dollars for any end product, from toiletries and pink hammers to pornography. But where are those funds going? We need donations to count, research is key.

Recently the Susan G. Komen corporation put out a new campaign using a woman with stage IV breast cancer as their highlighted warrior. I’m encouraged that they are no longer hiding stage IV in the back room, however, the message is wrong. Again.

“Don’t let breast cancer win.”

No one living with metastatic breast cancer has a choice in the matter, we aren’t losers, but breast cancer WILL kill us. The statement on Komen’s stage IV survivor ad, as well as others I’ve read in various promotions, place the blame directly at those of us living with this disease. It’s our fault if we die, we didn’t fight hard enough. That’s the message. It’s insulting, insensitive, inappropriate, and complete bullshit.

In the US the message that seems most prevalent in the pink ribbon campaigns is that early detection saves lives. The truth is, early detection does not prevent metastases. Plain and simple. If you have early stage breast cancer, it can come back, metastasize, turn your life upside down and eventually cause death. The market seems saturated with misguided information and greed, the focus has been corrupted, change is needed.

I personally stay away from anything that says “Komen.” Their message, their million dollar plus legal fights to keep “for the cure” to themselves, and the questionably high salary that the their founder takes home, are all concerning. It is my personal opinion that they are the bully foundation for what is known as the bully cancer. And why are we known as the bully cancer? Probably due to the pink ribbon culture.

There are other organizations that direct a much greater percentage of funds towards research verses awareness. The Canadian Breast Cancer Foundation is one of those organizations, and is transparent regarding fund allocation.

METAvivor‘s mission is quite clear, 100% of all donations goes towards metastatic research. Please check them out if you want more information.

Breast cancer doesn’t kill you until it metastasizes, yet stage IV seems mostly ignored within the Pink Ribbon culture. At least that’s how I felt a few years ago and I don’t feel all that differently right now. I wrote about my views in two posts, starting with Fifty Shades of Pink, back in 2013. That post will link to the next, my rant. At that time, I did not think I’d still be alive come 2015.

No amount of positive thinking is going to change the outcome of metastatic breast cancer. Research will.

What advice would you give someone who truly does want to help the breast cancer community, especially those with metastatic breast cancer?

Educate yourself, share the reality of breast cancer, share the truth of metastatic breast cancer, and don’t be afraid to talk with those of us living with MBC.

Be mindful that many of us, especially those with mets, don’t care about saving the ta-ta’s, boobie’s, the girls. Many of us don’t even have breasts. We care about saving lives. Life goes on after your breasts are amputated. We want parents to raise their children and watch their children grow, couples to enjoy the years together that they hoped for. We want to enjoy our lives and live without debilitating side effects, no matter our ages.

Many of us are insulted by the facebook games and various campaigns that go around claiming they are spreading awareness of breast cancer. One example was the popular no-bra day. I feel those games are trivializing our condition, and continuing to sexualize our disease. Every day is no-bra for some of us. This type of activity is not helpful. Those who play the games, and those who see them, are most assuredly fully aware of breast cancer.

Please visit these organizations for information on breast cancer and MBC:

Canadian Breast Cancer Foundation
Breast Cancer Consortium
BCSM (Breast Cancer Social Media) Community
LBBC (Living Beyond Breast Cancer)
MBCN (Metastatic Breast Cancer Network)
METAvivor

How can someone diagnosed with early stage breast cancer be a good ally to those with stage 4?

Once immersed in life with metastatic breast cancer I quickly became knowledgable with respect to it’s randomness and ultimate end. I then realized that when I was diagnosed and dealing with stage III breast cancer I didn’t have a clue about metastatic breast cancer. I had pamphlets, and one book that my original oncologist contributed to, which I read, though I’m not sure the very real possibility of becoming metastatic sunk in. I’m going to be just fine! I’ve had my surgery and treatments, I’m outta here!

I’d like to think that landscape is changing, people with early stage disease are better informed, personally informed, in your face informed, and not just handed a few things to read. But, it’s probably more likely that because I’m now fully immersed, I am fully aware, and because those I write and talk with are fully aware, I often assume others are as well.

We have work to do. Education is so important. The reality is hard to swallow but necessary to accept. That’s how change happens.

Keep in mind that those of us who were not diagnosed with stage IV from the start, once walked in your shoes. Living with stage IV, metastatic breast cancer, is in some ways similar to going through the various treatments for early stage breast cancer, two differences being that our treatments are forever, and our condition worsens until breast cancer kills us. There are obviously other differences, but hopefully my point makes sense.

Please remember that your breast cancer can come back at any time, I’m not trying to be a fear monger and certainly don’t wish you to live with constant dread, but I feel it’s important to remain realistic and vigilant.

Metastatic breast cancer is a widespread global killer of both sexes, young, old, and in between. In 2012, 524865 women and 3324 men died of metastatic breast cancer. Many MBC deaths go unreported as such, therefore the true numbers are higher.

If you wish to help us be heard, educate yourself about Metastatic Breast Cancer (stage IV), don’t pretend it doesn’t exist, and help us spread it’s reality.

Change is on the horizon! I might even live to see some of it. That’d be cool.

I’d like to thank Lara Huffman for allowing me this opportunity to share my views and concerns with respect to metastatic breast cancer.

You can read my story, rants, and musings at Art of Breast Cancer and if you are so inclined, follow me on Facebook, twitter, google+, and pinterest.

1 in 8

During this year’s Pinktober, did you happen to come across the “1 in 8 women will develop breast cancer in their lifetime” statistic? Here are three screen caps with this statistic:

Now from the American Cancer Society’s website:

A Komen affiliate website:

1in8

I actually learned recently that this 1 in 8 statistic is actually a teensy bit misleading. Lifetime risk isn’t the same of your actual risk based on your age. You know what blows my mind? I found actual scientific information explaining this statistic on Susan G. Komen’s website (I know, knock me over with a feather):

Women in the U.S. have a “1 in 8” (or about 12 percent) lifetime risk of getting breast cancer [4-5]. This means that for every eight women in the U.S. who live to be age 85, one will be diagnosed with breast cancer during her lifetime.

Source: Komen

So next time you come across the “1 in 8 women will develop breast cancer in her lifetime,” keep in mind the second part of that statement: “who live to the age of 85.”

I don’t know why charities and organizations use that statistic so much and with little explanation. Maybe they want to scare people into thinking breast cancer is going to happen to everyone or maybe they don’t really understand the lifetime risk vs. absolute risk?

My friend AnneMarie, over at Chemobrainfog, wrote:

One in eight is a good springboard for a fundraising campaign. It makes for a great way to terrorize those who do not understand that the number applies across your entire lifetime and it increases with age. As you are seated around your table with eight family members of different generations or eight close friends, don’t try to figure out who, unless you also incorporate WHEN into the equation.

There are certain factors that increase your risk of developing breast cancer, and I fell in several of those categories: family history, dense breast tissue, certain benign (not cancer) breast problems and not having children (and related to that, not breastfeeding). No doubt that these factors definitely increased my risk more than the 0.4 percent figure stated above. Plus, now that I’ve had breast cancer, I’m also at an increased risk for developing breast cancer again. Since treatment ended, I have made changes to my lifestyle, such as running and not drinking alcohol, among others, to minimize my risk because I never ever want to go through that again.

Cancer can often feel like a numbers game, although many doctors and specialists in the field will emphasize that you are an individual, not a stat. When you fall on the bad side of these statistics, these numbers almost seem cruel. I had less than one percent chance of going into anaphylaxis during chemo, yet that happened to me. Cancer is definitely not something I ever wanted to be unique at.

I truly believe it’s important for us to know our risks and what we can do to minimize our risks for developing breast cancer. First, we need to fight through the Pink Ribbon rhetoric seemingly designed to scare the general public with statistics without little or no context.

Guilt

Last night I found out that a Twitter friend of mine, Jada, had died of metastatic breast cancer at the age of 35. I stared at my screen – stunned. Although her Tweets had shown a decline and nothing but bad news for her, it still felt like a punch to the gut to hear of her death.

Jada is not the first #bcsm friend of mine to have died of breast cancer. Jen Smith, who wrote the blog Living Legendary, died of metastatic breast cancer in 2013, leaving behind a young son Corbin. In her interview with Lisa Bonchek Adams, another metastatic breast cancer blogger and advocate, Jen said:

I know society and the media have conditioned us to use the language “battle” against cancer, or in the “fight/war” against cancer. This is something that I’ve never really felt connected to. After all, what am I battling? A rogue cell in my own body, so in essence, I’m fighting myself. The best quote I’ve found that relates to how I feel is when Elizabeth Edwards died in 2010. Her friend said, “Elizabeth did not want people to say she lost her battle with cancer. The battle was about living a good life and that she won.”

The other frustrating thing I run in to is “So-and-so tried XYZ therapy and was stable for 10 years, why haven’t you done that one?” Then I explain that I tried XYZ and had progression in 3 months. I think getting people to truly understand that this is such an individualized disease is key. Just because XYZ works for one person doesn’t mean all people will respond the same way.

And, this is just me, personally, but I hate being referred to as “sick.” I’m not sick; I have a disease called metastatic breast cancer. If I was “sick” that would imply that I’m possibly contagious or that I’ll get better, neither of which are true.

When I hear about another death from metastatic breast cancer, not only do I feel sadness but I feel guilty. Why them and not me? What did I do that they didn’t do? What did I have in my favor that they didn’t? Survivor’s guilt, I believe is the term for this feeling. Jada was 35, and I’m going to turn 34 in two months. I followed her Twitter feed and often thought: This could have been me.

This still could be me.

You see, my guilt is not just confined to survivor’s guilt. Maybe it’s my Catholic upbringing or the fact that breast cancer has brought out all the feeeeeels in me. Perhaps both?

I have felt guilty that my two years of health issues have severely postponed plans to start a family (or realistically, completely cancelled them altogether). The idea of having children with someone like me, someone who can go from healthy to incredibly ill with little to no warning, is enough for The Boyfriend to reconsider having a family. The thought of raising a child or children by himself is too much. (Yes, yes, I know – nobody’s future is guaranteed, and I have heard: “But you can get hit by a bus tomorrow,” but a tragic accident versus a prolonged illness are two different scenarios.) The Boyfriend has every right to be scared, as his feelings are valid.

In his defense, I have wondered if I should have children and possibly leaving young children behind without a mother, too, like how I grew up. I wish I could tell him that it’s going to be okay, and we’ll never ever have to deal with cancer again. I can’t. I don’t know that.

I have felt guilty that I no longer want to talk, interact or even be in the same room as my step-family, thus creating a lot of stress and pressure on my dad. His life is centered around this family, and I accept that. I just no longer want any of them in my life. I did tell him that if he ever was sick and needed me, I’d be down there in a heartbeat, and I wouldn’t be a dick to the step-family. I won’t be fake nice or phony. I know that my refusal to see the step-family as my family will cause stress and tension in get togethers, but I chose my path and I intend to stay on it. I don’t see any of the steps apologizing to me.

Going through breast cancer treatment made me re-establish priorities in my life, and when I realized that people who were supposed to be my “family,” didn’t care about me, I cut them out of my life. If someone doesn’t care about what happens to me when I have cancer, I don’t care about them.

I have felt guilty that I am not the pink ribbon loving, platitude spewing and survivor banner carrying woman who has had breast cancer. I’m not that woman, and I often wonder if my refusal to play in the pink party has made others uncomfortable or downright afraid of me. Initially after I was done with active treatment, I briefly flirted with the identity as a pink ribbon breast cancer survivor. After learning the truth and reality of breast cancer and the pink ribbon, I walked the other way. Ran, even. That’s not the type of person I want to be after cancer.

(I do not fault anyone who wants to embrace the pink ribbon and the survivor label. If it brings you peace and comfort, let it continue to do so.)

I have felt guilty that I haven’t become the Forever Changed woman who has had cancer. I didn’t completely overhaul my diet and lifestyle. Some individuals have changed their entire lives, and I’ve probably made a fraction of the changes. Sure, I have started running and have pretty much cut alcohol from my life. However, I couldn’t tolerate Tamoxifen and stopped after six months because the side effects were too much. Every time I have come into contact with someone who takes Tamoxifen and also lives a BPA, paraben, chemical, sugar free life, I am overcome with guilt, feeling weak-willed. I wish I was strong enough to have tolerated Tamoxifen or changed every aspect of my life. I think about my inability to take Tamoxifen often, often wondering if I doomed myself. Then I feel guilty that I can put my loved ones through this again because I wasn’t strong enough.

Whenever someone I have made a connection with because of breast cancer dies from this disease, my heart hurts. Jada was a beautiful woman, and her death just goes to show how much more work needs to be done.

RIP, Jada.Walt Whitman (1819–1892). Leaves of Grass. 1900.

166. O Me! O Life!

O ME! O life!… of the questions of these recurring;
Of the endless trains of the faithless—of cities fill’d with the foolish;
Of myself forever reproaching myself, (for who more foolish than I, and who more faithless?)
Of eyes that vainly crave the light—of the objects mean—of the struggle ever renew’d;
Of the poor results of all—of the plodding and sordid crowds I see around me;
Of the empty and useless years of the rest—with the rest me intertwined;
The question, O me! so sad, recurring—What good amid these, O me, O life?

Answer.

That you are here—that life exists, and identity;
That the powerful play goes on, and you will contribute a verse.